Cuts to the workforce are being made, but often not on the scale planned. Where boards say why, they point to patient demand and safety putting a brake on their plans.
Which trusts set a target, missed it, or reported a reduction20 · 13 · 16
Set a target (20):
Alder Hey Children's · Countess of Chester Hospital · East Cheshire · East Lancashire Hospitals · Lancashire Teaching Hospitals · Liverpool Heart and Chest Hospital · Liverpool University Hospitals · Liverpool Women's · Manchester University · Mersey and West Lancashire Teaching Hospitals · Mid Cheshire Hospitals · North Cumbria Integrated Care · Northern Care Alliance · Pennine Care · Stockport · Tameside and Glossop Integrated Care · The Christie · The Clatterbridge Cancer Centre · University Hospitals of Morecambe Bay · Wrightington, Wigan and Leigh Teaching Hospitals
Missed it (13):
East Cheshire · East Lancashire Hospitals · Lancashire Teaching Hospitals · Liverpool University Hospitals · Manchester University · Mid Cheshire Hospitals · North Cumbria Integrated Care · Northern Care Alliance · Pennine Care · Stockport · Tameside and Glossop Integrated Care · University Hospitals of Morecambe Bay · Wrightington, Wigan and Leigh Teaching Hospitals
Reported a reduction (16):
Blackpool Teaching Hospitals · Bolton · Countess of Chester Hospital · East Lancashire Hospitals · Lancashire Teaching Hospitals · Lancashire and South Cumbria · Liverpool University Hospitals · Liverpool Women's · Manchester University · Mersey Care · Mersey and West Lancashire Teaching Hospitals · Northern Care Alliance · Pennine Care · The Clatterbridge Cancer Centre · University Hospitals of Morecambe Bay · Warrington and Halton Teaching Hospitals
In both groups (7): they made some of the cuts they planned but still ended the year above the level their own plan set.
East Lancashire Hospitals · Lancashire Teaching Hospitals · Liverpool University Hospitals · Manchester University · Northern Care Alliance · Pennine Care · University Hospitals of Morecambe Bay
Set a target, no outcome held (3): Alder Hey Children's · Liverpool Heart and Chest Hospital · The Christie — a statement about our holdings, not about the trusts.
Reported a reduction with no target in the papers we hold (5): Blackpool Teaching Hospitals · Bolton · Lancashire and South Cumbria · Mersey Care · Warrington and Halton Teaching Hospitals
Targets differ in scope: some cover permanent staff, others only agency or bank hours or funded-but-unfilled posts — each trust’s card states which.
Did the workforce actually get smaller?
Of the 13 trusts that set a target and can be compared, 9 ended the year with more staff than they started it; 4 ended with fewer. Of the 6 with no target held, 3 also grew. Whole-time-equivalent staff, all groups, NHS England figures.
See the numbers as a table19 trusts
| Trust | 2025/26 | Apr 2025 | Apr 2026 | Change | Change, share |
|---|---|---|---|---|---|
| Bolton | no target held | 6,087 | 5,837 | -250 | -4.1% |
| Lancashire and South Cumbria | no target held | 7,216 | 7,004 | -211 | -2.9% |
| Alder Hey Children's | set a target | 4,106 | 3,980 | -127 | -3.1% |
| Wrightington, Wigan and Leigh Teaching Hospitals | set a target | 6,351 | 6,236 | -114 | -1.8% |
| Mersey Care | no target held | 10,210 | 10,148 | -62 | -0.6% |
| Countess of Chester Hospital | set a target | 4,406 | 4,372 | -34 | -0.8% |
| East Cheshire | set a target | 2,402 | 2,395 | -7 | -0.3% |
| Greater Manchester Mental Health | no target held | 6,797 | 6,800 | +3 | +0.0% |
| The Walton Centre | no target held | 1,455 | 1,461 | +6 | +0.4% |
| The Clatterbridge Cancer Centre | set a target | 1,818 | 1,848 | +29 | +1.6% |
| Mersey and West Lancashire Teaching Hospitals | set a target | 9,912 | 9,966 | +53 | +0.5% |
| Tameside and Glossop Integrated Care | set a target | 4,270 | 4,338 | +69 | +1.6% |
| North Cumbria Integrated Care | set a target | 6,240 | 6,328 | +88 | +1.4% |
| Mid Cheshire Hospitals | set a target | 5,043 | 5,139 | +96 | +1.9% |
| Stockport | set a target | 5,620 | 5,722 | +102 | +1.8% |
| Northern Care Alliance | set a target | 18,516 | 18,623 | +107 | +0.6% |
| Cheshire and Wirral Partnership | no target held | 3,775 | 3,888 | +112 | +3.0% |
| Pennine Care | set a target | 4,071 | 4,223 | +152 | +3.7% |
| The Christie | set a target | 3,808 | 3,966 | +159 | +4.2% |
What this covers, and who is left out
NHS England workforce statistics, whole-time-equivalent staff in post, all staff groups — so it counts everyone working for the trust, not permanent staff alone, and a trust can shed permanent posts while its total holds up.
12 trusts are left out because a merger, transfer or reclassification during the year breaks the comparison:
- Liverpool University Hospitals — estates and facilities staff and services transferred back into the trust from a private provider; UHLG group corporate-services TUPE, formal transfer date the first of April, mobilised the previous day
- Wirral University Teaching Hospital — corporate services moved between Wirral Community and Wirral University Teaching as part of partnership working between the trusts
- Warrington and Halton Teaching Hospitals — Bridgewater Community Healthcare absorbed
- Liverpool Heart and Chest Hospital — UHLG group corporate-services TUPE, formal transfer date the first of April, mobilised the previous day
- Liverpool Women's — UHLG group corporate-services TUPE, formal transfer date the first of April, mobilised the previous day
- Wirral Community Health & Care — corporate services moved between Wirral Community and Wirral University Teaching as part of partnership working between the trusts
- Bridgewater Community Healthcare — stopped reporting during the year
- Manchester University — unexplained step changes in its monthly figures, so the year-on-year change cannot be read as a trend
- Blackpool Teaching Hospitals — One LSC shared corporate-services transfer; LSC pathology single service transferred to LTH as lead provider on the first of April
- East Lancashire Hospitals — One LSC shared corporate-services transfer; LSC pathology single service transferred to LTH as lead provider on the first of April
- Lancashire Teaching Hospitals — One LSC shared corporate-services transfer; LSC pathology single service transferred to LTH as lead provider on the first of April
- University Hospitals of Morecambe Bay — One LSC shared corporate-services transfer; LSC pathology single service transferred to LTH as lead provider on the first of April
Where the posts went
In August 2025 about 1,800 staff were moved in the national figures from East Lancashire to three neighbouring hospital trusts. Most work in the corporate services East Lancashire runs for the whole of Lancashire and South Cumbria: East Lancashire still employs them, but from that month they were counted at the trusts they work for. Nobody left and nothing was saved; because every trust is counted here, the move cancels out.
Managers, separately from the rest of the corporate workforceNHS England figures
Managers were not spared, but the weight of the reduction fell on administrative and clerical staff in central functions. Across all 31 trusts, senior managers fell by 2.9 per cent and managers fell by 1.1 per cent between April 2025 and April 2026 — against a workforce that shrank by 0.4 per cent overall. Because managers are a small group (about 4,900 posts, one in six of the infrastructure-support total), those falls amount to 84 of the 797 whole-time-equivalent posts lost from infrastructure support — about 11 in every hundred. The largest loss was among non-patient-facing administrative and clerical staff: 712 posts, one in every 23 in that group. Estates was flat.
| Staff group | Apr 2025 | Apr 2026 | Change |
|---|---|---|---|
| Professionally qualified clinical staff | 109,821 | 111,550 | +1,729 |
| Support to clinical staff | 59,953 | 58,257 | -1,697 |
| NHS infrastructure support | 31,935 | 31,138 | -797 |
| Senior managers | 1,714 | 1,665 | -49 |
| Managers | 3,223 | 3,188 | -35 |
| Central functions | 16,125 | 15,413 | -712 |
| Hotel, property & estates | 10,873 | 10,873 | -0 |
This table covers all 31 trusts, including the 5 that cannot be tracked trust by trust on the same basis, so its totals are larger than the figures above.
NHS England bundles managers, senior managers, non-patient-facing clerical staff and estates together as ‘infrastructure support’; a movement in the combined group says nothing about managers on its own, which is why the four are shown separately. This is a total across all 31 trusts, not a minimum. Qualified clinical staff rose while support to clinical staff fell by a similar amount; that can be a skill-mix change or posts reclassified between the groups, and NHS England’s data-quality notes record no reclassification for this period, so we leave it as unexplained rather than settled either way.
How the cuts were made, where trusts say55 reported reductions
Where a trust’s papers say how a workforce reduction was made, the commonest answer is leaving posts unfilled. Each entry below is one reported reduction; a trust can appear more than once.
‘No method stated’ means the paper names none — itself a finding. ‘Several methods at once’ means the trust itemises more than one.
The chart counts reported reductions, and only 5 are put down to a voluntary exit scheme — although at least 18 trusts have run one. Most papers do not say which lever produced which cut.
The levers, and why the trusts say they used them
Beyond permanent posts, workforce costs were reduced in a patchwork of ways. At least 18 of the 31 trusts ran a mutually agreed resignation or voluntary redundancy scheme; at least 26 operate recruitment controls — a vacancy panel or a freeze. Both are minimums: only trusts whose papers say so are counted.
Where a reason is given at all, it is overwhelmingly the savings programme: of the 29 trusts whose board papers say anything codable about the workforce, 19 state a reason in their own words and 16 of those cite their own efficiency-savings programme (CIP). 10 state no reason anywhere.
Voluntary exit schemes: who ran one18 trusts
At least 18 of the 31 trusts have run a mutually agreed resignation scheme (MARS), where staff are paid to leave by agreement, or a voluntary redundancy scheme. These are the trusts, in their own papers’ words. Few publish how many people left or what it cost.
| Trust | What its papers say |
|---|---|
| Cheshire & Merseyside | |
| Alder Hey Children's | “The MARs Scheme (Mutually Agreed Resignation Scheme) is under review, with 96 applications being assessed to balance staffing levels and service needs.” Alder Hey Trust Board Agenda — 5 February 2026 (Workforce commentary + Workforce Committee report) · p.152 |
| Bridgewater Community Healthcare | Launched jointly with Warrington and Halton: “both WHH and BCH have already launched” NC&M committees-in-common Board — 3 December 2025 · p.244 |
| Cheshire and Wirral Partnership | The board was asked for “retrospective approval from the Trust Board, for the implementation of a time limited Mutually Agreed Resignation Scheme” CWP Board of Directors public agenda pack, 18 September 2025 — minutes of the 30 July 2025 board, item 25-26-09a Mutually Agreed Resignation Scheme (MARS) · p.12 |
| Liverpool University Hospitals | “MARS scheme in place to support delivery of CIP” UHLG Board of Directors — 12 March 2026 · p.307 |
| Liverpool Women's | “3 employees left under the trust mutually agreed resignation scheme.” UHLG Board Public Information Pack — 15 January 2026 (LWH service-level workforce commentary) · p.39 |
| Mersey Care | 98 MARS agreements in 2025/26, in its annual accounts Mersey Care NHS Foundation Trust — Annual Report and Annual Accounts 2025-26, Table 5H non-compulsory departures (subject to audit) · p.88 |
| Mersey and West Lancashire Teaching Hospitals | “the national mutually agreed resignation scheme (MARS) leavers had also contributed to the slight increase of in-month turnover” Trust Board (Public), May 2026 · p.12 |
| The Walton Centre | “Applications were considered as part of the Mutually Agreed Resignation Scheme, 1 application was approved.” The Walton Centre Trust Board — April 2025 · p.28 “Adoption of the national NHS Voluntary Redundancy Scheme with authority to run a scheme as required in 2026/27” April Public Board Meeting — 2 April 2026 · p.517 |
| Warrington and Halton Teaching Hospitals | “launched a Mutually Agreed Resignation Scheme (MARS) as part of our wider” … W&H Council of Governors — 12 February 2026 · p.18 |
| Greater Manchester | |
| Greater Manchester Mental Health | “69 applications received, 61 applications rejected during the prepanel approval stages” … “8 applications had been presented to the MARS panel for approval.” GMMH BoD Part1 Public Full Pack 14 May 2026 — People Committee Chair's Report · p.26 “the Mutually Agreed Resignation Scheme (MARS) cost £80k, which was much lower than the expected £200k and resulted in recurrent savings of £1m instead of the anticipated £1.5m” GMMH Board of Directors (Part 1) public pack, 15 January 2026 — minutes of the previous (November 2025) Part 1 board, Chief Finance Officer's report · p.12 |
| Manchester University | “MARS scheme has recently been launched for which net recurrent savings will be realised in 2026/27” MFT Public Board of Directors papers, 1 October 2025 · p.484 49 MARS agreements in 2025/26, in its annual accounts Manchester University NHS Foundation Trust — Annual Report and Accounts 2025/26, non-compulsory departure payments note (subject to audit) · p.81 |
| Northern Care Alliance | “Workforce efficiency has progressed through vacancy holds and MARS delivery, but redundancy plans remain limited due to lack of deficit support.” NCA Board of Directors — 14 January 2026 (Workforce + Vacancy Hold report) · p.108 |
| Wrightington, Wigan and Leigh Teaching Hospitals | Its workforce report refers to a “recent MARS scheme” WWL Board of Directors Public Bundle — 3 December 2025 · p.65 |
| Lancashire & South Cumbria | |
| Blackpool Teaching Hospitals | Listed among its savings schemes: “T40 MARS - Organisational” BTH Board of Directors Public — 8 January 2026 (Appendix C: 21 PIRs / EQIA Panel tracking; WRP scheme list) · p.268-269 |
| East Lancashire Hospitals | Its finance report records a cost line: “MARS pressure £0.9m” ELHT Trust Board Agenda and Papers — November 2025 (M6 IPR finance commentary) · p.117+70+102 |
| Lancashire Teaching Hospitals | Its risk register records a “Gap in funding for any MARS schemes” LTH BAF Full Report April 2026 — PR-WTE-2627 (Workforce reduction BAF risk) + Finance & Performance Committee narrative · p.51 |
| Lancashire and South Cumbria | “launching a voluntary redundancy scheme, which has progressed to compulsory” LSCFT Board of Directors Public Meeting Papers — M11 (Feb 2026) · p.163 |
| North Cumbria Integrated Care | 12 MARS agreements in 2025/26, in its annual accounts North Cumbria Integrated Care NHS Foundation Trust — Annual Report and Accounts 2025/26, non-compulsory departure payments note (subject to audit) · p.77 |
A trust not listed may still have run a scheme: only trusts whose public papers say so are counted. Counts from annual accounts are MARS agreements, not people or posts.